Summarize the current recommendations for the following screening tests: low back pain, osteoporosis screening, cardiac screening, mammography, and pelvic exams
The current recommendations for these screening tests are:
• Low back pain: No imaging for low back pain within the first six weeks, unless there may be serious underlying conditions. Imaging of the lower spine before six weeks does not improve outcomes but does increase costs.
• Osteoporosis screening: No dual-energy X-ray absorptiometry (DEXA) screening for osteoporosis in women younger than 65 or men younger than 70 if they have no risk factors. DEXA is not cost-effective in younger, low-risk patients but is cost effective in older patients.
• Cardiac screening: No annual electrocardiograms (EKGs) or any other cardiac screening for low-risk patients without symptoms. False-positive tests are likely to lead to harm through unnecessary invasive procedures, overtreatment, and misdiagnosis.
• Mammography: Breast cancer screening with mammography may be considered in women 40 to 49 years of age, based on patients' values and on potential benefits and harms. Mammography is recommended biennially in women 50 to 74 years of age.
• Pelvic exams: Although pelvic exams have traditionally been performed to screen for sexually transmitted infections (STIs) and gynecologic cancers and to evaluate women before prescribing hormonal contraceptives, there is no scientific justification for such testing on a routine basis. Some physicians continue to perform routine pelvic examinations for several reasons, including standard medical practice, patient reassurance, and identification of uterine and ovarian conditions.
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